by Gregg Zoroya, USA TODAY

by Gregg Zoroya, USA TODAY

From 275,000 to more than 1.1 million Americans are caring in their homes for relatives wounded or emotionally damaged in the Iraq and Afghanistan wars, according to a RAND study being made public Thursday.

Little is known about these family members, researchers say. A typical profile is a woman, age 38 with young children, who faces decades of caring for a wounded husband.

Some work 80 hours a week assisting their loved ones with bathing, dressing, eating, using the toilet, making medical appointments, managing finances or struggling through emotional difficulties.

They "often toil in relative obscurity," the study says.

Researchers estimate that 800,000 servicemembers who deployed to Iraq and Afghanistan since 9/11 have suffered wounds, illnesses and injuries - the majority stricken with traumatic brain injury, post-traumatic stress disorder or depression.

"There is no national strategy for (their) caregivers," says former senator Elizabeth Dole, whose group Caring for Military Families: The Elizabeth Dole Foundation, funded the study. "We've got to raise awareness because most Americans are not aware of these hidden heroes."

In an aging American society, family caregivers have become a broader societal issue. But challenges faced by military family caregivers, whose loved ones may require decades of care, appear to be unique, says Terri Tanielian, the lead researcher.

"The consequences of those burdens could be more severe," Tanielian says. "It's taking a toll on them directly and that is kind of an unseen cost of war."

Drawing from caregiver focus groups and some limited published research, RAND researchers found that families caring for the wounded often wrestle with financial and legal issues, advocate for new treatments and navigate a web of government bureaucracies.

They lose wages, jobs and health insurance in the process, and see their own health suffer in some cases from the stress.

At the same time, they save the government untold sums of money by assuming care of these veterans. Often, children within the households also help, research shows. "Little is known about the impact ... on younger children," the report says.

Researchers found that recent federal legislation aimed at providing more assistance to military caregivers has been used by only a few hundred to a few thousand caregivers.

Dole said that she became passionate about the issue when her husband, former senator Bob Dole, a World War II veteran, was hospitalized temporarily in 2010 at what was then Walter Reed Army Medical Center.

"We've got to raise awareness (about these caregivers)," she says. "That's a woman sleeping on a (cot) by her husband's bed. Or it might be a mother keeping vigil over a son, wrapped up in blankets in a chair."

Dole says the funding is part of a broader effort by the foundation. Additional RAND research could shed light on the numbers and composition of military caregivers, their specific needs and actionable recommendations.

The foundation is also providing grants to: the National Military Family Association to develop caregiver best practices, the Military Officers Association of America to assist in providing legal and financial planning assistance to these families; and the Military Child Education Coalition to address the needs of their children.